"Soaring healthcare costs, combined with the recession, are threatening to undermine the gains from Massachusetts' 2006 healthcare overhaul, according to the third annual 'Update on Health Reform in Massachusetts' published today," The Boston Globe reports. The survey, conducted by the Urban Institute and published in the journal Health Affairs, found that "after seeing initial gains in affordability, an increasing percentage of residents are now reporting problems paying medical bills," and "a rising number of residents, especially those with lower incomes, are reporting that they did not get needed care because of costs, which are rising faster than inflation." In addition, the percentage of residents who reported using emergency rooms for nonurgent care has remained constant at about 15%, although "one key goal of the state's initiative was to drive down ER use - which can be expensive," largely because of a shortage of primary care physicians willing to take the public insurance.

But there were "many bright spots" in Massachusetts' universal coverage. Massachusetts boasts fewer uninsured residents than anywhere else in the county-- "less than 3 percent, compared with an average of about 15 percent elsewhere." There also was "a significant boost in the percentage of people who have been able to visit doctors and dentists," and "roughly 91 percent of residents said they have a regular healthcare provider, compared with 86 percent in 2006, when the health law went into effect" (Lazar, 5/28).

The New York Times adds that "the study's authors wrote that there were lessons for Washington, where Congressional committees are incorporating much of the Massachusetts model into federal health care legislation." One lesson, the researchers wrote is that "although major expansions in coverage can be achieved without addressing health care costs, cost pressures have the potential to undermine the gains." The Times also noted that "the difficulties in receiving care were severest among low-income residents." The new report "sets the stage for legislative recommendations expected next month from a state commission that hopes to slow the growth in health spending" (Sack, 5/28).

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